Do Vitamin B12 Supplements Cause Acne?

Michael Greger M.D. FACLM · November 30, 2020 · Volume 52

4.5/5 - (101 votes)

Acne can be triggered in one in ten people who get vitamin B12 injections.

Discuss

Transcript

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“Acne is a disease unique to humans.” “Why do humans get acne?” Well, think about the distribution of those greasy sebaceous glands—face, chest and back—exactly the same structures that pose the greatest obstruction during childbirth. So hey, maybe “having a [little] extra lubrication at these sites would help make the baby more slippery for birth conferring a selective advantage [for] successful delivery.” Okay, but what triggers them to become inflamed into zits later on?

While, in westernized societies, acne is a nearly universal skin disease afflicting up to 95 percent of teens, in some populations eating more traditional diets, not even single cases could be found. This suggests that perhaps “nutrition counseling [should be] a first-line…therapy for individuals with mild to moderate acne.” It looks like it’s the high-glycemic foods and dairy products; so, we’re talking sugar, soda, refined junky carbs, white flour, breakfast cereal, and dairy products like milk, cheese, yogurt, whey, as well as saturated and trans fats concentrated in meat, dairy, junk, and fast food.

So, for example, “acne patients should be encouraged to discontinue any whey protein supplements they might be taking.” “The relationship between milk and acne severity may be explained by the presence in dairy of normal reproductive sex steroid hormones or the enhanced production of [growth] hormones such as IGF-1.” And if you’re like, “Wait, I gave up dairy a month ago and still no change,” “it should be noted that changes in acne due to any….dietary changes are likely to take at least 10 to 12 weeks;” so, you have to stick to it.

Not surprisingly, “acne patients were more than twice as likely to have a non-vegan diet compared with controls,” but the difference did not reach statistical significance. So, maybe the vegans were eating a lot of vegan junk? But what about this: “Vitamin B12 Induced Acnes”? Our fellow great ape herbivores. like gorillas, get all the B12 they need practicing the eating of feces, but my preference would be to take B12 supplements. And you don’t have to worry about getting too much “because there are evidently no reports of adverse effects associated with excess B12 intake.” But that’s not true. First described back in the 1950s, about 1 in 10 people erupt in acne within days, or even just within hours of getting an injection of vitamin B12, which then disappears rapidly when you stop injecting them.

At the time, we had no idea what the mechanism might be––a problem still unsolved even up until just to a few years ago, but then we finally figured it out: Vitamin B12 modulates the gene expression of the skin bacteria that cause acne. They swabbed the skin of 10 people before and after being injected with Vitamin B12. It turns out that the level of B12 on your skin is proportional to the level in your blood; and so, after injection, the bacteria on your skin have to make less of their own B12. And so, the acne bacteria could concentrate instead on using its cellular machinery to churn out more compounds to attack your face. Without excess B12 on the skin––shown here in green––the bacteria has to make most of its own at the expense of porphyrins, which can trigger acne inflammation. When there’s lots of B12 floating around, the bacteria can not waste resources and focus instead on trying to pimple you up.

Okay, so wait; what do you do? Those on plant-based diets have to take supplemental B12. Yes, but we don’t have to get injections. Vitamin B12-related acne tends to occur only in dosages in excess of 5,000 to 10,000 micrograms a week––well in excess of the 50 micrograms a day I recommend, or alternately my 2,000-microgram single weekly dose. The only time you’d be taking between 5,000 to 10,000 a week is if you were treating B12 deficiency. If you remember from my previous video, B12 deficiency is treated with 1,000 micrograms a day for a month or more, and that could potentially trigger it, as noted in this vegan woman who wasn’t taking B12, developed B12 deficiency, and had to be treated with such high doses her face erupted in acne. So, all the more reason not to fall B12-deficient in the first place. But, look, if worse comes to worse, even if you do get B12 injections, the likelihood of it triggering acne may only be about 1 in 10.

Please consider volunteering to help out on the site.

Sources

Acknowledgements

Video production by Glass Entertainment

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“Acne is a disease unique to humans.” “Why do humans get acne?” Well, think about the distribution of those greasy sebaceous glands—face, chest and back—exactly the same structures that pose the greatest obstruction during childbirth. So hey, maybe “having a [little] extra lubrication at these sites would help make the baby more slippery for birth conferring a selective advantage [for] successful delivery.” Okay, but what triggers them to become inflamed into zits later on?

While, in westernized societies, acne is a nearly universal skin disease afflicting up to 95 percent of teens, in some populations eating more traditional diets, not even single cases could be found. This suggests that perhaps “nutrition counseling [should be] a first-line…therapy for individuals with mild to moderate acne.” It looks like it’s the high-glycemic foods and dairy products; so, we’re talking sugar, soda, refined junky carbs, white flour, breakfast cereal, and dairy products like milk, cheese, yogurt, whey, as well as saturated and trans fats concentrated in meat, dairy, junk, and fast food.

So, for example, “acne patients should be encouraged to discontinue any whey protein supplements they might be taking.” “The relationship between milk and acne severity may be explained by the presence in dairy of normal reproductive sex steroid hormones or the enhanced production of [growth] hormones such as IGF-1.” And if you’re like, “Wait, I gave up dairy a month ago and still no change,” “it should be noted that changes in acne due to any….dietary changes are likely to take at least 10 to 12 weeks;” so, you have to stick to it.

Not surprisingly, “acne patients were more than twice as likely to have a non-vegan diet compared with controls,” but the difference did not reach statistical significance. So, maybe the vegans were eating a lot of vegan junk? But what about this: “Vitamin B12 Induced Acnes”? Our fellow great ape herbivores. like gorillas, get all the B12 they need practicing the eating of feces, but my preference would be to take B12 supplements. And you don’t have to worry about getting too much “because there are evidently no reports of adverse effects associated with excess B12 intake.” But that’s not true. First described back in the 1950s, about 1 in 10 people erupt in acne within days, or even just within hours of getting an injection of vitamin B12, which then disappears rapidly when you stop injecting them.

At the time, we had no idea what the mechanism might be––a problem still unsolved even up until just to a few years ago, but then we finally figured it out: Vitamin B12 modulates the gene expression of the skin bacteria that cause acne. They swabbed the skin of 10 people before and after being injected with Vitamin B12. It turns out that the level of B12 on your skin is proportional to the level in your blood; and so, after injection, the bacteria on your skin have to make less of their own B12. And so, the acne bacteria could concentrate instead on using its cellular machinery to churn out more compounds to attack your face. Without excess B12 on the skin––shown here in green––the bacteria has to make most of its own at the expense of porphyrins, which can trigger acne inflammation. When there’s lots of B12 floating around, the bacteria can not waste resources and focus instead on trying to pimple you up.

Okay, so wait; what do you do? Those on plant-based diets have to take supplemental B12. Yes, but we don’t have to get injections. Vitamin B12-related acne tends to occur only in dosages in excess of 5,000 to 10,000 micrograms a week––well in excess of the 50 micrograms a day I recommend, or alternately my 2,000-microgram single weekly dose. The only time you’d be taking between 5,000 to 10,000 a week is if you were treating B12 deficiency. If you remember from my previous video, B12 deficiency is treated with 1,000 micrograms a day for a month or more, and that could potentially trigger it, as noted in this vegan woman who wasn’t taking B12, developed B12 deficiency, and had to be treated with such high doses her face erupted in acne. So, all the more reason not to fall B12-deficient in the first place. But, look, if worse comes to worse, even if you do get B12 injections, the likelihood of it triggering acne may only be about 1 in 10.

Please consider volunteering to help out on the site.

Video production by Glass Entertainment

Motion graphics by Avocado Video

Doctor's Note

This is part of my extended look at B12. For background and my updated recommendations, see:

All of these videos can be found in one digital download: Latest Vitamin B12 Recommendations.

I previously explored vitamin B12’s role in stroke risk. Check out:

That series is also available for digital download: Why Do Vegetarians Have Higher Stroke Risk?

Up next is Do Vitamin B12 Supplements Cause Bone Fractures and Lung Cancer?

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